Antibiotic treatment and antimicrobial resistance in urinary tract infections among the older population in Denmark, 1999 to 2023
Abstract
BACKGROUNDAntimicrobial resistance is highly correlated with inappropriate antimicrobial use. Urinary tract infections (UTIs) are the main infections treated with antibiotics in the population ≥ 70 years.AIMWe aimed to investigate antibiotic prescribing patterns for UTIs treatment among older people in Denmark and resistance trends to assess impact of antibiotic stewardship interventions and quality improvement strategies.METHODSThis national register-based surveillance study included people ≥ 70 years in Danish primary healthcare and assessed consumption of pivmecillinam, trimethoprim, nitrofurantoin and sulfamethizole from 1999 to 2023 and resistance levels from 2018 to 2023. Consumption data were obtained from the Register of Medicinal Product Statistics and resistance data from the Danish Microbiology Database. A review of quality improvement strategies from 2005 to 2020 was conducted to provide context for the study.RESULTSThe highest level of antibiotic consumption for UTIs in older people was in 2014 (447 prescriptions/1,000 people ≥ 70 years) and gradually decreased by 28.4% in 2023. Resistance to pivmecillinam, trimethoprim, sulfamethizole and nitrofurantoin in Escherichia coli and Klebsiella pneumoniae decreased significantly from 2018 to 2023, alongside the decline in antibiotic consumption. Focus on antibiotic stewardship was intensified after 2013, with several quality improvement initiatives and updated treatment guidelines aiming at improving diagnosis and…
Read the paper
Related studies
- Horizontal gene transfer in the human gastrointestinal tract: potential spread of antibiotic resistance genes
- Mutation supply and relative fitness shape the genotypes of ciprofloxacin-resistant Escherichia coli
- Genomic Survey of E. coli From the Bladders of Women With and Without Lower Urinary Tract Symptoms
- Characterization of cefotaxime-resistant urinary Escherichia coli from primary care in South-West England 2017–18
- Fitness cost constrains the spectrum of marR mutations in ciprofloxacin-resistant Escherichia coli
- Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.